Position Goal

Serves as a liaison between Hughston and third-party vendors.

Position Responsibilities:

• Responsible for direct communication and coordination with vendors and attorneys as it relates to claims management.
• Organize assigned clinic claims for electronic or hard copy mail and forwards to appropriate vendors, attorneys, and third-party payors as needed.
• Review claims to make sure that the payor specific billing requirements are met, follow up on billing, determine and apply appropriate adjustments, answer questions and update accounts as necessary.
• Responsible for monitoring claims processing, filing claims and collections for vendor and attorneys.
• Assist in managing assigned Payor hold/Manager hold buckets.
• Assist patients with questions/payments on their accounts.
• Serve as clinic representative for bankruptcy and deceased accounts.
• Provide ongoing training and support to Hughston team members on vendor and attorney claim processes.

Experience:

Required:

• Two years’ insurance claims/related experience.

Preferred:

• Four years’ insurance claims/related experience.

Education:

Required:

• High School diploma or equivalent

Special Qualifications:

Required:

• Knowledge of CPT and ICD-10 terminology.

Preferred:

• CRCR, CPAR, or other relevant certification.
• Experience with bankruptcy laws.
• Experience with auto and liability claims regulations.
• Familiarity with standard concepts, practices and procedures of this particular field

Candidates who are hired are eligible to receive a Healthcare Financial Management Association (HFMA) membership and access to certification trainings.

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.